• Korean Journal of Clinical Pharmacy
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• v.31 no.2
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• pp.96-103
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• 2021

Background: The number of elderly people with comorbidities who experience dysphagia associated with geriatric disorders, such as stroke, Parkinson's disease, and Alzheimer's dementia, is increasing. Consequently, the demand for long-term prescriptions of powdered medications is expected to rise. Most patients procure repackaged prescription medications from pharmacies; however, the guidelines regarding their expiration dates are unclear. Objectives: The aim of this study was to assess awareness among adults regarding the expiration dates and drug stability issues associated with repackaged prescription medications, including powdered medications. Methods: A questionnaire with 16 components was designed and distributed online (August 1-September 1, 2019) to adults aged 19 years or older. Statistical analyses, including descriptive analysis and chi-square test, were conducted on the obtained data. A p-value <0.05 was considered significant. Results: Data from 254 respondents were analyzed; 191 (75.20%) respondents worked in non-healthcare-related fields. A significant number of healthcare workers recognized the stability issues associated with powdered medications (p<0.001). However, a large proportion of healthcare workers were not aware of the expiration dates (p>0.05). Conclusions: More than half of the total respondents, including healthcare workers, were not familiar with the appropriate expiration dates of repackaged prescription medications. The establishment of evidence-based guidelines regarding drug expiration dates and the dissemination of awareness among patients are required. Furthermore, clinical practices including repackaging or pulverizing medications for long-term prescriptions should be avoided owing to the associated drug stability issues.

• The Journal of Korean Medicine
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• v.44 no.1
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• pp.1-15
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• 2023

Objectives: National health insurance herbal prescription of Korean medicine has been serving important role in public healthcare in spite of continuous demand on revision of system. However, the categories of insurance herbal prescriptions are not equally distributed throughout the KCD-based major disease categories. We analyzed statistical database of claimed national health insurance classified as major disease categories by years. We classified all 56 herbal prescriptions as per their total medical indications into 22 major disease categories to analyze their distribution. Significant increase of M and S-T code claims were found, whereas decrease of U code claims by years. We figured out that the 56 prescriptions were unequally distributed along with enrichment of certain codes such as K and J. Meanwhile, the insurance claim of each prescription was positively correlated with number of code types of their indications. As a result, we believe that the reform of national health insurance herbal prescription list is necessary to promote use of it in clinic.

• Korean Journal of Clinical Pharmacy
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• v.34 no.1
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• pp.30-38
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• 2024

Background: This study examined the public's perceptions of repeat dispensing as one of the measures to reduce the harmful effects of long-term prescriptions in Korea. Methods: From January 11 to 25, 2021, an online survey was conducted for adults using convenience sampling. A self-developed questionnaire was used. Results: There were 310 respondents, of which 228 (73.5%) preferred repeat dispensing. When considering the additional fee payment, 188 (60.6%) preferred repeat dispensing, and 54 (67.5%) out of a total of 80 chronic disease patients preferred it. It was confirmed that there was a difference in the willingness to repeat dispensing considering the additional cost depending on whether the patient had a chronic disease and the distance from home to the nearest pharmacy. As a result of subgroup analysis for patients with chronic diseases, frequency of outpatient visit, number of prescription days, method of packaging pharmaceuticals, and distance from home to the nearest pharmacy were identified as variables that could well predict the willingness to repeat dispensing considering paying additional fees. The preference for repeat dispensing may vary depending on conditions such as additional cost range, frequency and period of prescription use, disease and patient characteristics, so a careful approach is necessary. Conclusion: It is necessary for the government to consider the introduction of repeat dispensing with interest in the public demand.

• Journal of Biomedical Engineering Research
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• v.26 no.5
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• pp.343-349
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• 2005

Continuously motivating people to exercise regularly is more important than finding a way out of barriers such as lack of time, cost of equipment, lack of nearby facilities, and poor weather. Our proposed system presents practicable methods of motivation through a diverse exercise aid system. The Health Improvement and Management System (all-in-one system which saves space and maintenance costs) measures and evaluates a diverse body shape analysis and physical fitness test and directs users to automated personalized exercise prescription which is prescribed by the expert system of three types of exercise templates: aerobics, anaerobics, and leisure sports. Automated personalized exercise prescriptions are built into XML based documents because the data needs to be in the form of flexible, expansible, and convertible structures in order to process various exercise templates, BIOFIT, a digital exercise trainer, monitors and provides feedback on the physiological parameters while users are working out in the gymnasium. If these parameters do not range within the prescribed target zone, the device will alarm users to control the exercise and make the exercise trainer adjust systemically the proper exercise level. Numeric health information such as the report of the physical fitness test and the exercise prescription makes people stay interested in exercising. In addition, this service can be delivered through the Internet.

• Journal of Preventive Medicine and Public Health
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• v.35 no.1
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• pp.41-48
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• 2002

Objectives : To review the drug prescription pattern of antiulcerative agents for elderly inpatients, Methods : The study population comprised inpatients of community hospitals who were members of the Korean Elderly Pharmacoepidemiologic Cohort (KEPEC), aged 65 years or over, beneficiaries of the Korea Medical Insurance Corporation (KMIC) and residing in Busan city in 1993. The drug prescription information was collected from the claims data of hospitals where the cohort members received medical care between January 1993 and December 1594. The information included personal identification, age, gender, diagnosis, drug dosage, date of hospital admission and name of medical institutions where the study subjects received drug prescriptions. The data analysis produced outcomes in terms of distribution of antiulcerative agents by class and by medical institution and trend of relative prescription, Analysis was also performed in terms of combined prescriptions of antiulceratives and drugs that could induce risk from drug interaction with antiulceratives. Results : The number of patients prescribed antiulcerative agents was 1,059 (64,9%) male and 1,724 (65.5%) female among the total inpatients. An antacid and composite agent was the most frequently prescribed antiulcerative agent (70.8%), followed by $H_2$ antagonist (16.0%), Among the potential drugs that could induce risk from drug interaction with the antiulcerative agents, diazepam was the most frequently prescribed. The proportion of diazepam co-prescription was 22.5% of the total cimetidine prescriptions and 14.5% of the fetal omeprazole prescriptions. Conclusions : Antiulcerative drugs were frequently prescribed in the elderly inpatients. The adverse drug reaction could possibly be due to drug interaction. The study results could be used as fundamental data for further drug utilization review of antiulceratiye agents.

• The Journal of Korean Medicine
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• v.44 no.3
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• pp.189-200
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• 2023

Objectives: The purpose of this study is to analyze the current state of quantitative literature evidence for the prescription of 56 herbal medicines covered by health insurance that have been studied in Korea for the past 30 years, to evaluate the reliability of the evidence, and to find out the research direction of herbal medicine prescription in the future. Methods: 56 kinds of herbal medicine prescriptions were searched in domestic literature search databases OASIS, DBpia, and overseas PubMed, classified into chemistry, toxicity, cells, animals, clinical cases, and clinical trial studies, and built into an EBM pyramid structure. Results: When classified according to research contents, there were 61 cases (7.5%) of physicochemical analysis to identify constituent substances, 80 cases (9.8%) of toxicity evaluation, and 672 cases (82.7%) of efficacy evaluation. The efficacy evidence was classified according to the evidence-based medical pyramid structure: 196 cell trials (29.1%), 372 animal trials (55.4%), 89 case and case reporting series (13.3%), 7 comparative case studies (1.1%), and 8 randomized control clinical trials (1.2%). In the pyramid composition, the basis for the validity of 56 kinds of herbal medicines prescribed was 568 cases (84.5%) in cell and animal units, which could not be said to be highly reliable. There was no relationship between the ranking of quantitative literature evidence for herbal medicine prescriptions and the ranking of salary administration. Conclusions: In an era that continues to require scientific evidence for herbal medicine, traditional herbal medicine should secure the basis for safety validity even for the 10th most frequent prescription among 56 herbal medicine prescriptions for consumers. In particular, traditional herbal medicine should increase the quantitative and qualitative level of case reports on related herbal medicine prescriptions, focusing on each clinical society, and move toward comparative case studies and randomized clinical trial so that traditional herbal medicine is positioned as Evidence-based medicine.

• Journal of Physiology & Pathology in Korean Medicine
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• v.19 no.3
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• pp.633-639
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• 2005

The composition of Hwoangbaec-tang has been traditionally used in Korea to treat cancer. Hwoangbaec-tang I is the water extracts prepared from Angelica dahurica, Fritillariae verticillata, Ailanthus altissima, Viscum coloratun, Scutellaria Radix, Ginseng Radix, Astragalus membranaceus, and Glycyrrhizae Radix. Hwoangbaec-tang II also is the water extracts prepared from Ginseng Radix, Astragalus membranaceus, and Glycyrrhizae Radix. The anti-leukemic effects of human promyelocytic leukaemia (HL-60 cells) by Hwoangbaec-tang I or II was accessed by propidium iodide staining flow cytometric analysis, and apoptosis-inducing activity was further confirmed by a nuclear morphological change, a ladder pattern of DNA fragmentation, and an activation of caspase-3 and 9. Hwoangbaec-tang I was found to induce the apoptosis of HL-60 cells via caspase-3 and 9 pathway. In the other side, Hwoangbaec-tang II was found to inhibit the growth of HL-60 cells by inducing these cells to differentiate toward granulocytes. These results indicate that the different anti-leukemic effects of Hwoangbaec-tang in HL-60 cells can be induce the apoptosis or differnetiation of HL-60 cells in Hwoangbaec-tang composition dependent manner.

• Health Policy and Management
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• v.16 no.2
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• pp.49-76
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• 2006

The aim of this study was to explore the effects of a computerized review program which was introduced in August 1, 2003, using claims data for acute respiratory infection related diseases. National Health Insurance (NHI) claims data on respiratory infection related diseases before and after the introduction, with six month intervals respectively, were used for the analysis. Clinic was the unit of observation, and clinics with only one physician whose specialty was internal medicine, pediatrics, otorhinolaryngology and family medicine and clinics with a general practitioner were selected. The final sample had 7,637 clinics in total. Indices used to measure practice pattern was prescription rates of antibiotics, prescription rates of injection drug per visit, treatment costs per claim, and total costs per claim. Changes in the number of claims for major disease categories and upcoding index for disease categories were used to measure claiming behavior. Data were analysed using descriptive analysis, t-test for indices changes before and after the introduction, analysis of variance (ANOVA) for practice pattern change for major disease categories, and multiple regression analysis to identify whether new system influenced on provider' practice patterns or not. Prescription of antibiotics, prescription rates of injection drug, treatment costs per claim, and total costs per claim decreased significantly. Results from multiple regression analysis showed that a computerized review system had effects on all the indices measuring behavior. Introduction of the new system had the spillover effects on the provider's behavior in the related disease categories in addition to the effects in the target diseases, but the magnitude of the effects were bigger among the target diseases. Rates of claims for computerized review over total claims for respiratory diseases significantly decreased after the introduction of a computerized review system and rates of claims for non target diseases increased, which was also statistically significant. Distribution of the number of claims by disease categories after the introduction of a computerized review system changed so as to increase the costs per claims. Analysis of upcoding index showed index for 'other acute lower respiratory infection (J20-22)', which was included in the review target, decreased and 'otitis media (H65, H66)', which was not included in the review target, increase. Factors affecting provider's practice patterns should be taken into consideration when policies on claims review method and behavior changes. It is critical to include strategies to decrease the variations among providers.

• Mass Spectrometry Letters
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• v.5 no.1
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• pp.24-29
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• 2014

An advanced and reliable high performance liquid chromatography (HPLC)/ultraviolet detector (UV)/ion-trap time-of-flight (IT-TOF) mass spectrometry was developed for the simultaneous quantification of 19 marker compounds in Bang-poong-tong-sung-san (BPTS), a traditional oriental prescription. Various parameters affecting HPLC separation and IT-TOF detection were investigated, and optimized conditions were identified. The separation was achieved on a Capcell PAK C18 column ($1.5mm{\times}250mm$, $5{\mu}m$ particle size) using a gradient elution of acetonitrile and water containing 0.1% formic acid at a flow rate of 0.1 mL/min. The column temperature was maintained at $40^{\circ}C$ and the injection volume was $2{\mu}L$. IT-TOF system was equipped with an electrospray ion source (ESI) operating in positive or negative ion mode. The optimized electrospray ionization parameters were as follows: ion spray voltage, +4.5 kV (positive ion mode), or -3.5 kV (negative ion mode); drying gas ($N_2$), 1.5 L/min; heat block temperature, $200^{\circ}C$. Automatic $MS^n$ (n = 1~3) analyses were carried out to obtain structural information of analytes. Elemental compositions and their mass errors were calculated based on their accurate masses obtained from a formula predictor software. The marker compounds in BPTS were identified by comparisons between $MS^n$ spectra from standards and those from extracts. Moreover, the libraries of $MS^2$ and $MS^3$ spectra and accurate masses of parent and fragment ions for marker compounds were constructed. The developed method was successfully applied to the BPTS extracts and identified 17 out of 19 marker compounds in the BPTS extracts.

• Herbal Formula Science
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• v.19 no.1
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• pp.79-90
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• 2011

Objectives : This study was performed to analysis the composition of herbal formulations about a series of Wolgug-Hwan(WGH, formed by Gukchur-won and Sagung-san) in Dongeuibogam written by Heo Jun. Methods : The series of WGH in Dongeuibogam were selected by 'Prescription Lineage Graph' (http://164.125.206.43/PrescriptionLineageGraph.aspx) established by prof. Lee at Pusan National University. In the analysis of a series of WGH, we used some formulation books including classics. Results : Gaeuldogi-tang(GDT) is formed by WGH, Yeonggangchulgam-tang(YGT), Yugil-san (YIS) and Gungchul-san. Cheongul-san(CUS) is formed by WGH, Ijin-tang(IJT), YGT and Haegeum -hwan(HGH). Sosikcheongul-san(SCS) is formed by CUS and IJT. Jeungmiijin-tang(JIT) is formed by WGH, IJT, Sambaek-tang and Gyullyeonjichul-hwan. Sihoeokgan-tang(SET) is formed by WGH, Sihosogan-san(SSS) and Jigolpi-eum. Wolgukbohwa-hwan(WBH) is formed by WGH, Bohwa-hwan, Mokyangjichul-hwan and Hwangnyeon-tang(HNT). Chimsa-hwan(CSH) is formed by WGH, Injinho-tang(IHT), Yungmisamneung-hwan, Jeungmisamul-tang and Sinseongugi-tang. Conclusions : SCS, CUS, or JIT has been used frequently in case of phlegm-fire. These are formulated by the combination of WGH and IJT with Samseon-san or HGH or Jichul-hwan according to the special symptoms, respectively. SET which is formulated by WGH and SSS has been used in case of stagnation of liver-qi. GDT, WBH or CSH has been used in damp-heat. These are formulated by the combination of WGH with YIS, HNT, or IHT, respectively.